After Insure Tennessee falls, Catholics vow to keep fighting

Jennifer Murphy, right, executive director of the Tennessee Catholic Public Policy Commission, talks with Ann Harris, left, a member of the Saint Thomas Foundation board, Dawn Rudolph, the chief experience officer for Saint Thomas Health, and Greg Pope, chief mission officer for Saint Thomas Health, in the hallway of Legislative Plaza on Feb. 3. They were among a group from Saint Thomas Health meeting with legislators and urging passage of Insure Tennessee on the first day of committee consideration of the measure. Gov. Bill Haslam’s plan, laid out during a special legislative session, failed when a Senate committee voted to block further consideration of the effort that would have greatly expanded Tennesseans’ access to health insurance. Photos by Rick Musacchio

In the madcap days between when Gov. Bill Haslam made his case for Insure Tennessee to the State Legislature on Feb. 2 and when the Senate Health and Welfare Committee voted it down late Feb. 4, a number of Catholics descended on Capitol Hill to lobby in favor of the plan to expand health insurance to as many as 280,000 of the state’s working poor.

In the end, they left frustrated and defeated.

“That the legislators could be so deaf to the plight of the people in Tennessee is something that disturbs me greatly,” said Dr. Mike Schatzlein, chief executive officer of Saint Thomas Health. Schatzlein was among a contingent from Saint Thomas who spent time personally meeting with legislators, making the case for why passing Insure Tennessee was the right thing to do, from both a moral and a business perspective.

Insure Tennessee would have extended health insurance coverage to people who are caught in Tennessee’s “coverage gap,” unable to qualify for TennCare, the state’s Medicaid program, or for subsidies to purchase insurance through the Affordable Care Act marketplace.

Bishop David Choby was also on the phone with legislators in the first days of February, lending a voice of support to Haslam’s Insure Tennessee plan. “From the Church’s perspective, any effort to respond to the health needs of the people, based on the fundamental value and dignity of the person, deserves consideration,” he said.

“Many of us are fortunate enough to have our health care needs provided by our workplace, but not everyone has that good fortune,” Bishop Choby said. Government officials have a duty to find a way to extend health care coverage to the working poor and those too sick to work, he added.

Mike Schatzlein, at right, chief executive officer of Saint Thomas Health, led a group of Saint Thomas executives to meet with House Speaker Beth Harwell, pictured above, in her office to urge passage of Gov. Bill Haslam’s Insure Tennessee plan. The plan died in a Senate committee just two days after it was introduced by the governor.

Many of those who would have gained better access to health care through Insure Tennessee “are not lazy people,” said Jennifer Murphy, executive director of the Tennessee Catholic Public Policy Commission, the public policy voice of the Catholic Church in Tennessee. “These are people who may be working 40-plus hours a week, veterans, and college students,” she said.

The defeat of Insure Tennessee, Murphy said, was a “crushing blow” to those who worked hard to pass it, and to those who could have benefitted. By voting it down in committee, state legislators “chose to do nothing about a broken system,” she said.

In his Feb. 2 address to a joint convention of the 109th General Assembly, ahead of an extraordinary legislative session to consider his Insure Tennessee plan, Haslam explained that the program would be run as a two-year pilot program to provide market-based health care coverage to more than 250,000 Tennesseans who currently don’t have access to health insurance or have limited options. “It does not create any new taxes for Tennesseans and will not add any state cost to the budget,” he said.

The plan would have provided coverage to uninsured Tennesseans earning less than 138 percent of the federal poverty level, valued at slightly over $16,000 a year for an individual and $27,000 for a family of three.

Bottom line, Insure Tennessee would have “lowered costs and improved health outcomes” for the working poor of Tennessee, Schatzlein said. It also would have given rural hospitals a needed boost to receive those federal dollars that will now be left on the table. Saint Thomas operates a hospital in rural Hickman County “the only source of health care in the county,” according to Schatzlein, and if it were not part of the larger Saint Thomas Health system, it would likely fail, he said. “A lot of these smaller, unaffiliated hospitals will struggle.”

While the uninsured can access care at one of Saint Thomas’ low cost community clinics, many times people don’t realize they have that option, or they visit one time and don’t follow up with appointments. “Getting people into medical homes is the right way to do healthcare,” and that is much more effective when people are insured, Schatzlein said.

The fact that Insure Tennessee failed in a legislative committee before it was even brought to a full vote was very disappointing to Schatzlein and other Saint Thomas administrators, but, he said, it will only strengthen the hospital’s outreach efforts. “Our founders, the Daughters of Charity, charged us to care for the poor and vulnerable and we will continue to do that, regardless of people’s ability to pay,” he said.

Michele Johnson, executive director of the Tennessee Justice Center, which helps vulnerable populations gain access to health care, knows the heartbreaking stories of those who are stuck in the insurance “coverage gap” all too well. People like Michele Farden, who works as a home health care aide and helps care for her daughter and two granddaughters. She lost a daughter in July who delayed treatment for a blood clot because of lack of insurance.

Or people like Phillip Willis who worked at a funeral home and with a landscaping company until a back injury and chronic arthritis kept him from working. He is now living with his parents and using a low cost clinic for health care, where he must pay out-of-pocket.

“The people who we talk to all day every day are strong, faith-filled, generous people who make our community better and who are suffering and losing everything without insurance,” said Johnson, a lifelong Nashvillian and a parishioner at Christ the King Church. “Denying them coverage that is cost neutral to the state is tragic and small minded.”

“It’s going to be a long road ahead” to continue the fight to expand health insurance coverage to the working poor of the state, Johnson said, “and some people won’t survive that road.” The Tennessee Justice Center is not giving up in the face of defeat though. They have already been discussing with their supporters how to move forward.

Johnson and her staff will reach out to more people who lack insurance coverage, gathering and sharing their stories to increase awareness of the needs. “We will continue the hard work of trying to connect people who are isolated, and let them know that they matter,” she said.

Additionally, Tennessee Justice Center members are brainstorming how to better educate people across the state about the on-going need for health insurance expansion. Just before Insure Tennessee came up for a vote, “there was a poll that said the vast majority of Tennesseans didn’t understand it,” Johnson said. “We need to do a better job educating citizens.”

However, one reason people didn’t understand the plan, she said, was because of so much misinformation circulating, especially from out-of-state groups like the Americans for Prosperity, whose members, dressed in bright red t-shirts, swarmed Capitol Hill, working to defeat the legislation. The night of the vote, the organization sent out a press release thanking legislators “for listening to your constituents and voting to stop Obamacare’s Medicaid expansion in Tennessee.”

Even though Haslam tried to make it clear in his address to state legislators that Insure Tennessee was, in fact, not “Obamacare,” it did depend on federal money, and with such distrust between state legislators and the federal government, the plan was unable to gain traction.

While Johnson, Schatzlein and others working to pass Insure Tennessee were disappointed by the outcome, they say they are not giving up the fight for to expand health care access in Tennessee, and across the country. “At some point, everybody in America will have coverage,” Schatzlein said, “and we continue to work and pray for that."